POSTTRAUMATIC STRESS AFTER CHILDHOOD-CANCER .1. THE ROLE OF APPRAISAL

Life threat or physical injury have been shown to produce post-traumat ic stress symptoms in children. Recent studies have demonstrated that a subset of survivors of pediatric cancer report post-traumatic stress symptoms years after completing successful treatment. However, it is not clear whether these symptoms represent a response to the perceptio n of life-threat or to the repeated intrusive procedures that accompan y cancer treatment. In this exploratory study, 30 childhood cancer sur vivors 8 to 19 years old, who were at least 22 months off treatment wi thout recurrence of disease, were evaluated using self-report question naires. The survivor's appraisal of treatment intensity significantly correlated with the severity of post-traumatic stress symptoms. When a ge at the time of diagnosis was evaluated, appraisal of treatment inte nsity was significantly correlated with symptoms only in those six yea rs old and younger. For children aged seven years or older at the time of diagnosis, duration of treatment was a significant contributor to symptoms. Diagnostic category (leukemia or solid tumor), length of tim e since completion of treatment and the child's appraisal of life-thre at were not significantly correlated with severity of post-traumatic s tress symptoms. Further study of the impact of intensive pediatric tre atment on children and the importance of developmental factors in trau matic response to illness appears to be indicated.